Pediatric Pathology In The Year 2050.

The study of pathology in fetuses, infants, and children had its beginnings in the mid-19th century. Now, 165 years later, hundreds of pediatric pathologists are in up-to-date practices throughout the world. They, and all medical practitioners, are just beginning to delve into the nanotechnical wave.

Embryonic stem cell biology.

ES cell research represents an exploding field of exploration. Initially predicted to provide rapid cures for numerous human diseases, the clinical usefulness of ES cell-derived cells remains untested in humans. However, ES cells have rapidly expanded our knowledge of human development and the molecular details of differentiation.

Fraser syndrome: affected siblings born to nonconsanguineous parents and diagnosed at autopsy.

Fraser syndrome (MIM 219000) is a rare genetic disorder with major features including cryptophthalmos, syndactyly, and genital anomalies. We report 2 independently autopsied children of the same nonconsanguineous parents. The siblings exhibit similar clinical features, all of which are consistent with a diagnosis of Fraser syndrome.

The role of histone acetylation in regulating early gene expression patterns during early embryonic stem cell differentiation.

We have examined the role of histone acetylation in the very earliest steps of differentiation of mouse embryonic stem cells in response to withdrawal of leukemia inhibitory factor (LIF) as a differentiation signal. The cells undergo dramatic changes in morphology and an ordered program of gene expression changes representing differentiation to all three germ layers over the first 3-5 days of LIF withdrawal. We observed a global increase in acetylation on histone H4 and to a lesser extent on histone H3 over this time period.

Reference values for valve circumferences and ventricular wall thicknesses of fetal and neonatal hearts.

To evaluate valvular stenosis, cardiac dilation, and/or cardiac hypertrophy, measurements of valve circumference and ventricular wall thickness are of importance. To establish reference values in fetuses and neonates, we reviewed pathology reports at Women and Infants Hospital from 1978 through 2002 and found measurements in 776 cases that were suitable for analysis. Gestational ages (GA) ranged from 15 to 42 wk.

Reference values for second trimester fetal and neonatal organ weights and measurements.

To establish accurate reference ranges for the entire second trimester, we documented organ weights, body weight, and linear measurements for 597 fetuses and neonates with gestational ages ranging from 12 to 26 wk. We determined the mean and standard deviation for weights and measurements at each week of gestation using the StatView trade mark SE + Graphics statistical program. The analyses revealed a linear correlation between the gestational age and, respectively, the toe-heel length, crown-rump length, and crown-heel length.

Utility of HPV DNA detection in thin-layer, liquid-based tests with atypical squamous metaplasia.

Objective: To determine if testing for HPV is useful in the management of patients with atypical squamous metaplasia (ASM) and to evaluate a small group of patients with atypical squamous cells in the setting of an atrophic cellular profile (estrogen test [ESTT]).

Study Design: Presence of HPV DNA was determined on 104 ASM and ESTT cases on residual ThinPrep specimens using Hybrid Capture II. Results of the HPV DNA test were correlated with subsequent biopsy or repeat Pap test results.

Triplet placentas: reference values for weights.

The occurrence of twins, triplets, and other multiple births increased significantly between 1970 and 2000 in the United States and other industrialized countries. The number of triplet placentas submitted for examination as pathologic specimens has also markedly increased, but no reference values are published for triplet weights. We examined 196 normal triplet placentas.

Reference values for transverse cerebellar diameter throughout gestation.

The transverse cerebellar diameter (TCD) is well established in the ultrasound literature as a reliable parameter for estimating the duration of gestation. In cases of growth restriction the cerebellum is usually spared, making TCD a reliable indicator of gestational age even when other parameters fall off the appropriate growth curve. The purpose of this study is to establish normal values for the transverse diameter of the cerebellum in pathology specimens, and to determine if these values correlate with those obtained by ultrasound.

Demonstration of placental vascular anatomy in monochorionic twin gestations.

Invasive treatment modalities for severe chronic twin-to-twin transfusion syndrome (TTTS), such as fetoscopic laser coagulation of communicating vessels, have revived the need for detailed studies of placental angioarchitecture. We describe a practical placental vascular injection technique using alcohol-resistant tissue-staining dyes. Injection of color-coded gelatin-dye mixtures effectively delineated the intertwin vasculature, and allowed unequivocal macroscopic classification of vascular communications as artery-to-artery, vein-to-vein, or deep artery-to-vein anastomoses.